Does sequential atrioventricular pacing improve cardiac output compared to ventricular pacing in patients with heart block complicating acute myocardial infarction?
Sequential atrioventricular pacing significantly improves acute hemodynamics, including cardiac output, compared to ventricular pacing in patients with heart block complicating acute myocardial infarction.
The hemodynamic effects of ventricular pacing and of sequential atrioventricular pacing were compared in nine patients with second-degree or third-degree heart block complicating acute myocardial infarction. The restoration of normal atrioventricular relations resulted in an increase in cardiac output in each case (average values of 2.9 to 3.6 liters per minute, or 24 per cent — p less than 0.001). Significant rises in arterial pressure and falls in venous pressure were also obtained. Because of the small number of cases and the short study period, the overall clinical effect of sequential pacing could not be assessed, nor could an opinion be formed concerning its effect on prognosis.
Chamberlain et al. (Thu,) studied this question.